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Deaths From Ebola Without Infection

wbaiThe number of people infected with Ebola is now over 2,200, with more than 1,200 people dying from the virus. But the death toll from Ebola in Liberia may be much higher as it seriously compromises the country’s health care system.  Buzzfeed’s Jina Moore reported from Monrovia this week that the country’s Minister of Health estimates that 75% of the deaths are women who are in formal or informal caregiving roles. This includes nurses, who have been infected while caring for patients. Some of these patients were thought not to be infected but later died from the virus. Others were known to be infected, but the nurses and others caring for seriously ill patients with Ebola have been lacking the personal protective equipment that we take for granted in the U.S.  In a nation that already suffered from a shortage of nurses and other health care workers, Ebola has killed some health care workers and has caused others to leave hospitals. Those needing health care for other reasons may fear going to hospitals or clinics and, if they do go, may find that the hospital has closed because it doesn’t have enough staff. Pregnant women who needed help with complicated deliveries have died, and it is estimated that people with other health conditions other than Ebola are also dying because of a lack of health care.

Today on Healthstyles, c0-producer and host Diana Mason, PhD, RN, talks with three nurses with recent experience in Liberia about that nation’s capacity for delivering health care now and in the future: Harriette Dolo, Liberian certified midwife and registered nurse who is Director of the Esther Bacon School of Nursing and Midwifery at Curran Lutheran Hospital in Zorzor, Lofa County, Liberia (the county with the highest incidence of Ebola); Dorcas Kunkel, DNP, RN, APHN, assistant clinical professor of nursing at the University of Minnesota and volunteer faculty at the Mother Patern College of Health Sciences in Monrovia, Liberia; and Magdeline Aagard, RN, EdD, nurse educator and international consultant who is also a volunteer faculty at the Mother Patern College of Health Sciences.

Tune in today at 1:00 to Healthstyles on WBAI, 99.5 FM (www.wbai.org), or click here to listen to the interview:

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

Digital Literacy May Protect Against Cognitive Decline

Can digital literacy delay cognitive decline?

Researchers think it might. In a recently published study in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences they found that digital literacy — the ability to engage, plan, and execute digital actions such as web browsing and exchanging e-mails — is an independent protective factor against cognitive decline.

Using data from the English Longitudinal Study of Ageing, they followed 6,442 participants in the UK between the ages of 50 and 89 for eight years. The data measured delayed recall from a 10-word-list learning task across five separate measurement points. Socioeconomic status, including wealth and education, comorbidities, and baseline cognitive function were included in the models.

senior-computerHigher wealth, education and digital literacy improved delayed recall, while people with functional impairment, diabetes, cardiovascular diseases, depressive symptoms or no digital literacy showed decline.

Those who reported being nonusers of Internet/E-mail and intermittent users showed cognitive decline; in contrast, current users increased their delayed recall capability, with a difference of more than 8.63 percent over the follow up period. Although the group with lower cognitive function at baseline presented higher CD, this group also demonstrated a significant variation in percentage change of the word recall, with better performance for those who used Internet/E-mail.

The effect of digital literacy was independent of age and socio-economic status, suggesting that digital literacy increases cognitive reserve or improves efficiency of cognitive networks to delay decline.

More people in the UK are using the Internet than ever before, however 6.4 million — about 10 percent of the population —  say they have never gone online. Of those, 74 percent are over age 65 and half are from socially disadvantaged backgrounds. In comparison, Pew Research reports that about 20 percent of all Americans don’t go online, and 41 percent of those over age 65 in the U.S. do not use the Internet at all.  Older adults comprise almost 13 percent of the U.S. population.

The authors write, “countries where policy interventions regarding improvement in digital literacy are implemented may expect lower incidence rates for dementia over the coming decades.” Perhaps something policymakers on both sides of the pond should consider.

Is Grandma In An RN-ing Home?

This post is by CHMP’s Amanda Anderson, RN. More frequently than not, Amanda writes toward her simple goal, “I want nurses to start talking.” Here, she reflects on a recent newspaper article calling for registered nurses in all nursing homes, all day. Find more of her thoughts on her blog, This Nurse Wonders, and tweets, as @12hourRN.

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Only thirteen states require registered nurses on site in nursing homes for 24 hours a day, despite direct evidence of their benefit. Photo credit @tuddysgirl.

Please imagine my surprise, when I surfed to The New York Times yesterday evening in search of updated news on the Ferguson riots, only to be drawn to a sidebar highlighting the title, “Where Are the Nurses?

Could it be?! My trusty paper, oft neglectful of my prized profession, showcasing nurses in a headline story? A mix of fear (nurses walking out on Ebola patients), and curiosity (staffing, really?) pushed me to click the hyperlink so foreign from my initial target.

The article turned out to be about staffing, more specifically, an Illinois politician’s goal of getting a registered nurse into each nursing home for each hour of the twenty four in a day. Not an LPN, or a certified nursing assistant, a Registered Nurse. Well, shucks, this was a happy distraction.

The proposed bill, “Put A Registered Nurse in The Nursing Home Act,” hit Congress July 31st, and calls attention to the mountains of evidence for our presence in inpatient care – reduced risk and bettered outcomes. The article, sharing a paragraph of links to the evidence, goes as far as saying that to have a registered nurse in-house all day long, makes “care improve, but cost less.”

Incredible. Nurses, and nurses all day long, and all night long, directly leading to safer, healthier, less-compromised patients? And for cheap?

Jan Schackowsky, the representative fighting for this requirement, called out the obvious – the suspected 11% of nursing homes that lack a 24 hour registered nurse (only 13 states in the country require one all day) shouldn’t really be titled nursing homes. She suggests the tongue-in-cheek name: “well-intended residences for the incurably underattended to;” a quick browse of the reader comments attests to the sad truth of this title.

These residences often staff with licensed practical nurses, or nurses aides, but as the article clearly outlines, “…only registered nurses are trained and licensed to evaluate a patient’s care and conduct assessments when his or her condition changes, which can happen rapidly — and at 3 a.m.” Without an ever-present, licensed practitioner on site, these residences for convalescence have no business advertising themselves with our trusted title. Why is this reality so infrequently stated? Does our acquiescence to this false representation speak to our lack of definition as a profession?

Perhaps nurses need to start recognizing how important our registered work is to the preservation of our patient’s health and safety, and to start protecting our right to a safely staffed, and properly titled workplace. If the nursing home does not provide a registered nurse, the public should know about it – and they should know why our absence matters, as much as our presence.

I hope this bill gets made into law. But I don’t just hope for that; I hope Schackowsky changes the vernacular of nursing, too. With a registered nurse required, maybe “nursing home” will be replaced with “Registered Nursing Residence,” and the public, and patients, will begin to demand nothing less.

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Correction: “Associate nurse” was replaced with “certified nursing assistant.” Associate-degree nurses sit for the same licensing exam as Bachelor-prepared nurses, and thus, hold the title, “registered nurse.” For more information on the different types of nurses, visit allNursingSchools.com’s overview here

Healthstyles Today: “Observation Status”–Policy Gone Wrong?

wbaiAcross the country, people on Medicare who become ill are being admitted to hospitals on what is called “observation status” or “admit to observation” to provide regular assessments to ensure that the patient’s condition doesn’t deteriorate and require a higher level of care. Medicare pays less for observation status since it’s assumed that the patient needs less care. It makes sense, but in reality it’s creating huge problems for some of the patients, their families and the hospitals. The issue has become a national concern and New York State has responded with legislation aimed to provide some protection for Medicare patients who are admitted to the state’s hospitals.

Today on Healthstyles on WBAI 9.5 FM (www.wbai.org), producer and host Diana Mason, RN, PhD, talks about this issue with Toby Edelman, Senior Policy Attorney in the Washington, DC, office of the Center for Medicare Advocacy. You can listen to the interview here:

The program will open  with HealthCetera, Healthstyles’ highlights of health news that today includes information about Ebola; followed by a discussion with new Healthstyles producer, Kenya Beard, RN, EdD, ANP, about the recent report on health disparities by the Agency for Healthcare Research and Quality. You can listen to this interview here:

Today’s program opens with HealthCetera, Healthstyles’ highlights of health news.

So tune in today at 1:00 to WBAI, 99.5 FM.

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

OPEN LETTER TO ANNA

Joy Jacobson:

This is a repost by Lacy M. Johnson. Her new memoir is “The Other Side,” which asks, Kelle Groom writes, “How is it possible to reclaim the body after devastating violence?” This letter seems to me to emphasize something undeniably important: the power of one person’s story to affect the lives of others. I’ll be reading her book soon.—Joy Jacobson, CHMP senior fellow

Originally posted on Lacy M. Johnson:

Dearest Anna,

It’s been almost a month since the New York Times’ published its investigation of the many ways in which Hobart and William Smith Colleges mishandled your sexual assault, and in that time Congress has introduced a new bill that relies primarily on stiff fines and strict reporting guidelines to shame institutions of higher education into better accountability. It’s progress, maybe, but that’s not why I’m writing. I’m writing because there’s a picture of you in the newest Times article — in which Senator Kirsten Gillibrand is announcing the new bill into a rack of microphones, and you’re standing beside her, papers in hand, mascara running.

I am writing to you because I know how it feels to stand in front of a room of powerful people and describe all the ways you’ve been made to feel weak. How the tears are not weakness but rage, though no one would believe you if you tried to explain…

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